From the outside looking in, it seems as if not much has changed in regards to the “Pay or Play” provisions for employers after this morning’s ObamaCare Supreme Court ruling to uphold most parts of the ACA (Affordable Care Act).
So far, in plain terms, here is what I know in regards to the law (from our company’s health insurance broker & attorney):
- The opinion is extremely complex, and it will hopefully be sorted out soon.
- The requirement that most Americans buy health insurance or pay a fine is constitutional as a tax. Not as a penalty.
- The pay or play provisions that employers are nervous about, are most likely still in place, but not much has been said about that as of yet.
- The pay or play penalties (or taxes – however they will word it) for employers will most likely change from the initial proposed $3,000 per employee penalty.
- The states need to get their crap together now and set up these exchanges (since we still don’t know what it will look like state by state). They’ve got a year-and-a-half to get it done.
Basically, companies are still most likely damned if they and damned if they don’t… but we don’t know how damning it is… yet.
Yes, for sure, we know that individuals will be taxed if they do not take insurance, but they all still agree that American businesses will be the major supplier of funding for the ACA. Someone has to pay for it, right?
On a happy note: 32 million uninsured Americans can be covered by 2014. I mean, really, is that a bad thing? Probably not.
But we are so divided over this decision as a country.
So I hope all of us who were hoping for certain aspects (or the whole darn thing) to be declared unconstitutional, will realize that it’s helping those that were uninsured or under-insured. Hopefully we can all see that there are good things and bad things with this whole thing. And one thing is for sure, things are going to be-a-changing around this joint.
Crap, I don’t know how it’s going to all play out. No one does as of this minute. And they are lying if they say they do. This needs to be picked apart by attorneys who can interpret all of this legal-speak.
I have a conference call tomorrow at 2pm, where I will be told how the decision affects American businesses after a team of attorneys reads this very complex decision all day today and overnight tonight. Just check back with me tomorrow once I get off that conference call and know more things.
In the meantime, I’ll just be sitting here, drinking from this flask I keep in my desk, and eating my humble pie.
So what are your thoughts today? Are you stoked or stroked?
{ 18 comments… read them below or add one }
Can I sit in on your conference call?! I’m 2% happy, because kids will be cared for. And no child will be socially stunted because of birth defects that are fixable….I’m 98% disgusted. But I won’t get into that yet, as I just keep dropping f-bombs.
Random corollary of the day: how much smoother and/or more effective would this entire process, and the resultant law, have been if we were to toss all the lawyers out of Congress and replace them with engineers? Things to make you go “hmm…”
happy. and i’m planning on blogging about why i’m happy. the short version is that more people will be covered. from what i’ve heard, only about 16% of americans will ‘have to’ buy their own insurance or pay the tax/penalty.
and, really, we all pay for it already. think about all the uncovered people who go to the emergency room for a fucking COLD. they don’t pay their bills – WE DO. we’re already paying for other people’s healthcare. what pisses me off is that the insurance companies are just businesses with shareholders who seem to not give a fuck about the PEOPLE they are selling policies too. i’m hoping that ACA will help change that because the companies will be forced to compete in those exchange thingies. in a perfect world, it would benefit everyone.
of course, in a perfect world, communism looked great on paper.
I’d love to meet these people who have gotten “free care” at an ER.
I went with cysts on my thyroid, one was so big I couldn’t swallow. The hospital wouldn’t do the 5 biopsies until my husband left me there, went to the bank and came back with a certified check for $650.
My next ER visit was for a severe cut on my ring finger that needed 10 stitches. I was told “If we clean it and stitch it, it will be $600. If we clean it and don’t stitch it, it will be $100-$200 dollars. We need the money before we can let you see the doctor” I left with no stitches.
I would LOVE to have health insurance if I could find a company that doesn’t say “Hmmm, diabetic with a cystic thyroid and degenerative spine disease…that will be $1200 a month please”
Sounds like you two are basically mad about the same things. The cost of healthcare. And how it needs to be more accessible.
i’d love to know what hospitals you went to. no hospital can refuse to help someone who is sick or injured – they cannot turn anyone away, even if they have no money, no id, no nothing. i had a friend who had no insurance and almost cut his finger off. he went to the hospital where they had to do surgery. he owed them well over $10K at one point and he just never paid. it kept going to collections and he just kept ignoring it because he worked off the books and they couldn’t prove he had any money to take. (please notice i said HAD a friend.)
It was a nationwide private hospital system owned by a huge Christian denomination.
Their mission statement is based on “extending the healing mission of Christ”.
When I was standing there with my finger split open, looking at the bone and weeping, the woman at the desk kept saying “I’m sorry, this is our policy” and staring at me until I made a decision. I had to make the decision to get it cleaned and hope there was no permanent damage.
My husband has great insurance through his job ( Meredith will understand….he’s in management for a great car dealership). The insurance company premium to add me to the group policy is equal to one week’s pay every month. I don’t blame my husband’s company, I blame the insurance company.
I can’t see how the insurance companies can be stopped from charging whatever outrageous amount they like for people with pre-existing conditions.
I guess they weren’t REFUSING to treat me. They were just waiting for me to hand over the money BEFORE treating me. I could have made a decision to sit in the waiting room until the hand healed itself.
that’s sad, and not how hospitals are supposed to work. awesome husband also works for a car dealership as a diesel technician and has great coverage. hell, if he was only covering himself it would be FREE. but since i’m on it, we pay the same – about one week’s worth of pay every month to have me on the policy. it’s disgusting when we have had to choose in the past between keeping our insurance and being able to pay bills. and that’s what ACA is *supposed* to fix – old people shouldn’t have to choose between medication and food, and people who work in jobs that don’t offer health insurance have an opportunity to buy affordable health insurance.
I, like you Meredith want to know more about what this really means and will wait, hopefully for a neutral explanation, not one charged with Republican, Tea Party, Democratic rhetoric mixed in to incite the masses.
Nevertheless, this one hits close to home, after my 26 year old sister, who has had 10 surgeries over the last 23 years for tumors in her head, and has had no insurance for the last 5 years, was admitted to the hospital after she woke up Tuesday morning and her entire eye had shifted and inch and a half over towards her ear. Her last surgery, covered by my father’s military benefit was in 2007, and since then there have been no routine 6 month CAT Scans or MRI’s to monitor the tumors and their progression. She’s not been sitting on her ass doing nothing either. She been busting her tail feathers getting her B.S. and Masters Degree, and working two part time retail jobs at 50 hours a week, and looking for a full time job in her field.
So why all of a sudden does she have the attention of an army of Doctors? BECAUSE HER EYEBALL IS SLIDING OFF HER FACE!! And to think if she had, had some insurance 3, 4, 5 years ago, she could have received the medical attention to prevent this and we wouldn’t be worrying about whether she will go blind, or if her eye will ever go back where it should be, or if this young beautiful woman who has accomplished so much and has such a bright future, will have a future at all.
I know this is our individual story, and I’m not suggesting public policy should be based on my family’s situation, but I know we aren’t the only ones and there are a lot of people out there that have major and minor health issues for which they receive no or only emergency care. Just doesn’t seem right to me. And for those lucky ones (myself included) with health insurance, who get to pay their $20 or $30 copay and go to the Dr. anytime they feel it is warranted, my sister envies you, and I get why you aren’t jazzed about paying more for these uninsured people. There will always be two sides of this and it will always be complicated, but for a minute I’m going to be grateful for today’s ruling, and then I’m going to go help my sister get ready for her surgery tomorrow.
I’m one of the uninsured Americans. I make too much to qualify for government insurance (yet with my income and family size still sit 150% below the federal poverty level) but not enough to pay for it through my employer and because I have a “preexisting condition” (colon cancer in 1997) I do not qualify for “pay for your own” insurance. I should be having regular colonscopies and am currently dealing my 2 of the 3 nervous systems in my body slowly shutting down (damaged caused by a year of chemo) and I endure excruciating pain on a daily basis because of it. Yet I don’t see a dr because I can’t afford it. I’m one of those Americans that will die an early death because I cannot afford to treat myself medically. I’m all for this plan and I hope like hell it passes!
From what I understand Canada has a higher “tax” (sin tax, they call it) on booze that pays into the healthcare system. Is America going to do that?
WON’T SOMEBODY THINK OF THE BOOZE?
I like the idea!
So happy I can’t stop smiling! But then I work in a place where most people don’t have insurance and get to decide between food and healthcare. Recent patient: Had breast cancer in 2010. Has 2 close family members dieing of ovarian cancer. Can’t get the genetic testing to determine that she carrys the BRCA1/2 gene, because of the expense. Terrifying.
I’m interested to see how it all plays out as well. As a parent though I’m very happy with the changes because it means my 3 year old with a pre existing condition will probably be able to get insurance for the rest of her life. When she was first in the process of buying her individual insurance so I could stop paying $500 to my work every month. When she was diagnosed buying private insurance for her was no longer an option. Eventually my hubby got a new job and was switched over to his plan.
Also. I do know people who have gone to the e.r and have had everything paid for.
I’m all for it, everyone having health care is a GOOD thing. The people bitching about it and complaining the country is going down the toilet need a serious reality check.
Here is the thing – I am surviving cancer so I will benefit from the pre-existing clauses and the you have to cover regardless clauses for insurance companies. HOWEVER – this bill does absolutely NOTHING to reduce the premiums for the heath care that I will need. It DOES make stipulations about preventive care premium amounts which really no longer apply to me since every mammogram, CT scan, PET scan, MRI I receive is about making sure the cancer is gone or hasn’t spread.
As of right now I am fortunate enough to work for an employer that covers most of my insurance premiums but as the law stands now in 2018 if my employer chooses to play and continues to have insurance as a benefit I will be taxed 40% of the premiums paid for on my behalf. Based on the law as in now stands – financially I am screwed either way I run the numbers. So YAY insurance companies HAVE to insure me! BOO they can still charge me tens of thousands of dollars to cover me! AND if I choose not to pay for insurance coverage I get TO PAY THE GOVERNMENT $695 or 2.5% of my adjusted gross income (because I am single) depending on which number is higher!! WOO WHO!!!!
Parts of this law are great – but in my opinion it does absolutely nothing for the real problem in health care – MAKING IT AFFORDABLE.
I’m glad it passed because it’s a small step forward, because no one can be denied health insurance anymore … but really, it’s a band-aid. The entire system is broken; it’s so dysfunctional that it’s almost beyond repair, and half the country is so resistant to change that making what it should be (functional) will never happen, unfortunately. (Regarding “half the country”, I’m not referring to Dems v. Reps, just that people in general are resistant to massive change.) It’s just like the tax code.
It does make me worry when companies start talking about dropping their health insurance and just paying the fine instead. It seems counter-productive.